A study of students’ preferences for learning from real or simulated patients as part of early patient contact in the undergraduate curriculum

Introduction Medical students may learn history taking and clinical examination skills by practising with either real or simulated patients. As part of their second year, students at the institution take part in workshops whereby simulated patients are used to allow students to practise their clinical skills. At a minority of these workshops, real patients are recruited from the community in place of actors. This allows students to practise basic clinical skills with real patients. We sought to elicit students’ preferences for learning clinical skills from real or simulated patients. METHOD As part of a series of clinical skills workshops in year 2 of the undergraduate programme, a musculoskeletal workshop was organised for 218 students. In contrast to other workshops, real patients were recruited using hospital outpatient mailing lists. Small groups of students then rotated between patients, such that each student met with at least three patients over the course of the workshop. The patients had diagnosed rheumatologic disorders with clinical signs and symptoms. Students had the opportunity to take a history, practise their communication skills and examine patients. This was facilitated by clinical skills tutors. Subsequently, all students were invited to complete a brief anonymous online evaluation (See Table 1). Likert scales were used to elicit students’ preferences for learning. The students also had the opportunity to provide qualitative feedback. RESULTS The response rate was 50% at time of abstract submission. 74.3% preferred learning clinical skills with real patients. 91.6% enjoyed encountering real patients. 78.0% felt they were able to ask patients the questions they wanted to ask. 77.0% thought the workshop helped their confidence in communicating with patients. 78.8% felt more motivated to learn. 85.2% indicated that they had a more realistic understanding of musculoskeletal conditions as a result of seeing them in a real life context. 90.8% indicated that they had a better understanding of the impact of disease on patients’ lives. CONCLUSION Medical students exhibited a strong preference for learning clinical skills from real patients as opposed to simulated patients. Students indicated that practising with real patients made them feel more confident in their communication skills and more motivated to learn.